An EMS professional must be prepared to make the best medical decisions and the most appropriate legal decisions. EMTís must be familiar with the legal issues they are likely to encounter in the field.

Legal duties and ethical responsibilities.
EMTís have specific legal duties to their patients, crews, medical directors, and the public.

bulletLiability/legal responsibilities include performing 1) patient assessments, provide appropriate medical care, and maintain accurate and complete 2) of all incidents.
bullet3) standards are expected behavior and actions of a profession. Examples are meeting both physical and emotional needs of every patient, treat all patients with courtesy, maintain mastery of skills, and review your performance and constantly seek improvement.
bullet4) standards are expected behaviors and actions as a fellow human being.

In general there are 5 types of law.

bullet5) law can be described as practice that has become the standard. 
bullet 6) law is set by government. 
bullet 7) law is the government versus a citizen.
bullet 8) law is a dispute between two or more citizens.  Another term for this law is 9)  law.
bullet 10) law is rules of an agency.  For example if an EMT renews their certification late a punitive charge may be added.

Laws affecting EMS and the EMT

bullet11) is when a physician allows a lower level skill professional work under their license and supervision.
bullet12) is what the EMT has been taught.
bullet13) describes the acceptable treatment to be provided.
bullet14) is acknowledgement by an national organization to practice.
bullet15) is acknowledgment by a local body to practice.

Mandatory reporting requirements

bulletA 16) of spousal, child, elder and/or sexual abuse must be reported.
bulletGunshot and 17) wounds along with 18) bites must be reported.
bullet19) diseases must be reported to the appropriate health department.  If the communicable disease is 20) in nature and the patient is a 21) the information may not be released to the parents.

Legal protections for the paramedic

bullet22) laws are intended for the lay public to provide basic care to fellow citizens without the expectation of charging a fee. 
bullet23) White Act is a tool which may allow an exposed EMS worker to obtain specific medical history or a patient in case a disease transmission took place.

Components of a negligence claim

bullet24) to act
bullet25) of duty
bullet26) Actual
bullet27) Proximate

All FOUR must be proven for negligence.

Off-duty EMT

bulletIf an off-duty EMT comes upon an MVC they 28) have a duty to act.  If the EMT stops to render aid they 29) have a duty to render basic care until equal or higher skill level arrives.

Paramedics have legal and 30) duties to protect their patientsí privacy and treat them with honesty, respect, and compassion.

Confidentiality

Situations allowing release of patient information

bulletAs general practice an EMT cannot release private information without patient 31) for release of records.
bulletOther medical care providersí need to know to provide appropriate care.
bulletLegal requirement to release a patientís medical records like a 32) or 33) .
bulletThird-party billing requirements
bulletHealth Insurance Portability and Accountability Act which is abbreviated 34) .

Defamation

bullet35) is false written communication
bullet36) is false oral communication
bulletBreach of 37) is release of any type of personal private information.

Consent           

bulletInformed consent is also known as 38) , 39) , 40) , and 41) .  In all of these cases the patient is given information from cost of procedure, risks, benefits, and needs then gives a clear indication on their wishes.
bulletConsent is needed from all competent adults over the age of 42) .
bulletA&Ox4 stands for 43) and 44) times 4 questions; 45) , 46) , 47) and 48) .
bullet49) consent is when the patient is mentally unable to make rational decisions related to their care.
bulletInvoluntary consent is a type of 50) consent in which the patient is competent but the behavior is physically endangering their lives.  Example; behavioral crisis suicidal. 

Special consent situations

Minor is usually under age 51) unless they are 52) , legally 53) , 54) , and active 55) .

At any time a competent adult may withdrawal consent at 56) during care.  The patient may choose 57) only with no care or care only and no 58) .

 

Refusal of service at a minimum requires

bulletBe sure patient is a 59) adult.
bulletMake multiple and sincere attempts to convince patient to accept care. Enlist help of others such as 60) members and friends to convince patient to accept care.
bullet

Be certain the patient is fully 61) about the implications of decision and risks of refusing care. Advise patient that he may call again for help if needed.

bullet

Consult with on-line 62) direction. Document the entire situation 63)  on the patient care report.

bulletHave patient and witnesses 64)  release-from-liability form. The best witness is a 65) member/spouse or bystander.

Legal complications related to consent

bullet66) is not leaving the patient in the care of a equal or higher skill level.
bulletAssault and battery Ė 67) is the threat of unwanted physical contact. 68)  is the act of unwanted touching.
bulletFalse 69) is withholding freedom of movement to a competent person. 

Resuscitation issues. Generally, you are under obligation to begin resuscitative efforts when summoned to the scene of a patient who is unresponsive, pulseless, and apneic. Sometimes, however, you will determine that resuscitation is not indicated.

70) directives is a generic term used when a patient expressed their wishes in advance of a medical situation.

bullet71) provide specification of the kind of medical treatment a person is willing to accept.
bullet72) orders indication by patient of what types of life-sustaining measures will be permitted if heart and respiratory functions cease.
bulletPotential organ donation.

Death in the field. Crime and accident scenes. You should be familiar with crime-scene preservation issues, but you must not sacrifice patient care to preserve evidence or to become involved in detective work.

bulletContact law enforcement.
bulletProtect yourself and the safety of other EMS personnel.
bulletInitiate patient contact only when a crime scene has been deemed safe.
bulletDo not move or touch anything unless it is necessary for patient care; protect evidence.
bulletIf you need to remove items from the scene, document your actions and notify police.

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FROM THIS POINT ON COMPARE YOUR ANSWERS WITH CLASSMATES.  NO ANSWER KEY WILL BE PROVIDED WHEN CLICKING "CLICK HERE TO GRADE" AT BOTTOM OF PAGE.

1. As a paramedic, one of your ethical responsibilities is to treat all patients with .

2. Your best protection from liability is to be thorough and perform assessments.

3. The area of law in which the federal, state, or local government will prosecute an individual on behalf of society for violating laws meant to protect society is law.

4. Elements of include proof that the EMT was the proximate cause of actual damages to the patient.

5. To show the existence of proximate cause, the plaintiff needs to prove that the to the patient was reasonably foreseeable.

6. The act of injuring a personís character, name, or reputation by false or malicious statements spoken with malicious intent or reckless disregard for the falsity of those statements is called .

7. If you respond to a 7-year-old child with a life-threatening injury and no parent or guardian is available, you may still treat the child because of consent.

8. If a competent adult refuses care, you should the situation thoroughly.

9. The termination of the paramedic-patient relationship without assurance that an equal or greater level of care will continue is termed .

10. A paramedic who starts an IV on a patient who does not consent to such treatment may be sued for .

11. During transport of a patient to a health care facility, the level of care the patient receives must (may) be at least the level of care received at the scene.

12. A document created to ensure that certain treatment choices are honored when a patient is unconscious or otherwise unable to express his choice of treatment is called a(n) directive.

13. If you have any doubt about whether a order is valid, you should initiate resuscitation efforts.

14. Which type of form gives instruction to withhold CPR.

15. When you are treating a patient at a crime scene, your responsibilities include trying not to touch the body at all if the patient has an obvious mortal wound such as decapitation.

16. Regarding documentation the patient report should be completed   after patient contact.

17. A legal document that allows a person to specify the kinds of medical treatment he wishes to receive should the need arise is called a living will.

1. The best protection from liability is to perform assessment, provide appropriate

care, and maintain accurate and complete .

2. The paramedic must treat patients and their families with and .

3. A civil wrong committed by one individual against another is called a(n) .

4. The law that is derived from societyís acceptance of customs and norms over time is called law.

5. is a process used to regulate occupations.

6. refers to the recognition granted to an individual who has met predetermined qualifications to participate in a certain activity.

7. The range of duties and skills paramedics are allowed and expected to perform is their .

8. You may function as a paramedic only under the supervision of a licensed physician through a delegation of authority.

12. cause is the action or inaction of the paramedic that immediately causes or worsens the damage suffered by a patient.

13. is the act of injuring a personís character, name, or reputation by false or malicious statements written with malicious intent or reckless disregard for the falsity of those statements.

14. If your patient is able to make an informed decision about medical care, he is considered .

15. Consent for treatment granted by the authority of a court order is called consent.

16. A person under the age of 18 years who is married, pregnant, a parent, a member of the armed forces, or financially independent and living away from home is considered a(n) minor.

17. The unlawful touching of another individual without his consent is .

18. Intentional and unjustifiable detention of a person without his consent or other legal authority is called .

19. Preserve at a crime scene whenever possible.

20. A well-documented patient report is completed promptly after

                                                            

1. Termination of the EMT-patient relationship without assurance that an equal or greater level of care will continue.

2. Consent for treatment that is presumed for a patient who is mentally, physically, or emotionally unable to grant consent.

3. Range of duties and skills paramedics are allowed and expected to perform.

4. Legal responsibility.

5. A breach of duty by failure to perform a required act or duty.

6. Exemption from legal liability.

7. An intentional false communication that injures another personís reputation or good name.

8. A formal contractual or informal legal obligation to provide care.

9. The unlawful touching of another individual without his consent.

10. A civil wrong committed by one individual against another.

11. A breach of duty by performance of a wrongful or unlawful act.

12. Provision that gives immunity to certain people who assist at the scene of a medical emergency.

13. Division of the legal system that deals with wrongs committed against society or its members.

15. The division of the legal system that deals with noncriminal issues and conflicts between two or more parties.

16. Deviation from accepted standards of care recognized by law for the protection of others against the unreasonable risk of harm.

17. The degree of care, skill, and judgment that would be expected under similar circumstances by a similarly trained, reasonable paramedic in the same community.

19. The principle of law that prohibits the release of medical or other personal information about a patient without the patientís consent.

                                  

Think about this:  If an AIDS pt cuts his finger cutting lettuce is it relevant to tell the emergency room that the patient has AIDS?

Think about this: Is pt confidentiality violated by labeling the door to a unit ďAlzheimer Unit?Ē

Think about this: A school nurse calls EMS because a student is having a seizure.  The school nurse gives you a note from the patents that state, ďMy child has a history of seizures.  Only transport if she does not wake up normally.Ē

Think about this: A baby sitter calls 911 because the child she is watching is 6 years old and cut her finger with scissors doing a project.  You are getting ready to transport and the parents come home and state that it is against their religion to accept medical care.  What do you do?

Think about this: You respond to a MVC of a 16 year old female who has a head laceration is A&Ox4, 6 months pregnant and refuses care.  What do you do?


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